The number of deaths investigated by the Lebanon County coroner’s office decreased for the fourth consecutive year in 2023.
After rising from 329 deaths in 2019 to a peak of 526 in 2020, the first year of the COVID-19 pandemic, the coroner’s office has continued to respond to fewer annual calls since the start of this decade. The office had 498 calls in 2021, 376 in 2022 and 340 in 2023.
Coroner’s office assistant Lorraine Jackson said COVID was the primary factor for the uptick in death investigations in 2020-21.
“We were basically investigating anything that came across in that regard, including everything coming through the hospital because we were basically tracking the numbers,” said Jackson. “Once COVID kind of made its exit, its major exit if you would want to call it that, where we saw the cases diminish drastically, it basically went back to business as usual where we were investigating the normal deaths that occurred.”
Jackson noted that prior to the onset of the virus the coroner’s office investigated every death anywhere other than in a hospital-type setting except for its emergency room.
“If a person died at home, or if they were involved in a motor vehicle accident or were found as a DOA (dead on arrival) in an odd place, all of those are investigated as they are now,” she said. “The only ones we don’t investigate are in-hospital or nursing home deaths unless there is something unusual about the nursing home death.”
While the number of overall coroner-investigated deaths has returned to pre-pandemic levels, drug overdose fatalities and suicides have remained at about the same levels since 2020.
There were 20 suicides in 2023, which is the same number as in 2022 and one more than in 2021. Death by firearm remains the method used most often when individuals commit suicide.
“Fifty percent were by firearm, so 10 of 20, which is important to note,” said Holly Leahy, director of Mental Health/Intellectual Disabilities/Early Intervention (MH/ID/EI).
As usual, there were more males on the list than females.
“We had 17 males and three females commit suicide with an average age of 46.7. The eldest was 95 and we had two 18-year-olds in 2023, which is kind of unusual for us to have those younger adults,” added Leahy.
Other methods were three by hanging, two self-inflicted lacerations, two intentional drug overdoses, one asphyxiation, and one suicide by standing in front of an oncoming train.
“It is our understanding that she had communicated to others her intention,” said Leahy. “There was also a note, so it was intentional.”
The three female suicide deaths was a steep drop over 2022’s total of eight.
“Historically, we don’t have that many females commit suicide. It is odd to have a higher number of females, and I don’t have anything to contribute to that and have no idea what made a difference (for fewer female deaths) in 2023,” said Leahy. “When we look at the data, that is completely an outlier. It is typical to have two or three females.”
Leahy said it was important to note that two veterans ended their lives in 2023. (Veterans who are struggling with their mental health are encouraged to reach out to the Lebanon VA Hospital for assistance.)
“The eldest was 95, one was 86, both were males, both were Caucasian,” she said.
It is not known why all but two of the 20 – including the veterans – chose to end their lives. Leahy said that there were only two notes found of the 20 suicides completed last year.
“For these two gentlemen, there’s nothing here to indicate any external factors,” she said. “In the past, we’ve seen historical things like a terminal illness or their wife passing away and they can’t live without her. There is nothing here and they did not leave notes.”
Leahy said suicide is hard to analyze since most individual don’t leave a note, which confounds experts as to why these individuals ended their lives.
“That’s what so hard about suicide is that it is conjecture and speculation and because most times you don’t have a note,” she said. “When we look at the data, most people don’t leave a note.”
That makes it especially hard for survivors in the wake of a suicide.
“So why they completed, what thoughts they had or whatever remains for their families makes it hard for their loss because they don’t have anything from the person who says, ‘I’m really sorry but I did it because. I really love you but I have to leave you,’” said Leahy. “There’s nothing like that, so they are left with all of these questions and unresolved feelings and it is hard for the loved ones and families of those who commit suicide.”
Leahy said these 20 individuals were not known to her department since they did not seek assistance prior to completion.
“We’ve seen that the people who have committed suicide are not known to the system,” said Leahy. “They are not known here in the county and they have not reached out for help. What it comes down to is that if you want to receive help, you have to reach out to the system, so it comes down to the person having to want to help themselves.”
Signs that someone is about to commit suicide is not usually apparent at that moment to their loved ones, family and friends.
“People see that their loved ones are doing great, they are doing well,” said Leahy. “And that’s because they are at peace with that decision, they are resolved and so the family doesn’t know and they believe their loved ones are doing fine.”
James Donmoyer Jr., director of the Lebanon County Commission on Drug and Alcohol Abuse, said there were 33 overdose deaths in Lebanon County in 2023, which is in the same range as the past few years. There were 29 in 2022, 31 in 2021 and 39 in 2020.
For the past several years, fentanyl, a powerful painkiller, has been the leading cause of deaths in drug overdoses, according to Donmoyer. Over 75 percent of drug overdose deaths in 2023 involved fentanyl.
“When fentanyl is mixed with other drugs, it is a lethal combination,” he said. “That’s what substances are being cut with. Some are doing straight fentanyl, some are cutting it with heroin.”
Another drug to make its debut in Lebanon County in 2023 was xylazine, a drug that’s legal for veterinarians to use to sedate large animals.
Donmoyer told LebTown last fall that it was only a matter of time until illegal xylazine was found on the streets of Lebanon County. As previously reported, xylazine is manufactured in a powder or pill form in China while the xylazine veterinarians use in their practices is highly regulated and is distributed in a liquid form.
Jackson, speaking on behalf of Lebanon County Coroner Dr. Jeffrey A. Yocum, said 2023 marked the first time that drug was present in overdose deaths in Lebanon County.
“We’ve seen it a couple of times in our toxicology, but up to this last year we hadn’t seen it before,” said Jackson. “None were xylazine alone. It was one of many, or several other, drugs that were present.”
Read More:
- Local veterinarians worried by proposed limits on drug linked to opioid epidemic
- Order bans illegal use of xylazine while protecting veterinarian practitioners
- Fentanyl is driving a surge in fatal overdoses in Lebanon County
Three of the 33 overdose deaths involved xylazine, added Donmoyer, with fentanyl and xylazine as the cause of 85 percent of all overdose deaths in 2023.
“Only five deaths didn’t involve fentanyl and xylazine,” said Donmoyer. “Fentanyl is a big issue already and xylazine is becoming a big issue as well. We hadn’t seen it in our city before but we heard about problems with it. Do I think the number of xylazine deaths will go up? Absolutely. Fentanyl? Probably.”
Donmoyer said both illegal drugs are being cut with other drugs. Drug dealers use these drugs because users seek the enhanced high from them compared to other narcotics, he noted.
The other 15 percent of illegal substances involved in ODs in 2023 were generally a toxic mix of a variety of drugs, including amphetamine, cocaine, heroin, methamphetamine and oxycodone, among others.
In drug overdoses in Lebanon County, the average age of individuals is on the rise. When Donmoyer started in his position 10 years ago, the average profile of someone who overdosed was a 34-year-old Caucasian male heroin user that was in the criminal justice system. Today, the average overdose age is 46.7, with their drug of choice being fentanyl – although heroin and alcohol are the two most abused substances. This past year, the oldest individual to have an accidental drug overdose was 75 years old, Donmoyer added.
“No one 25 and younger overdosed, so it is not a kid thing,” he said. “The average age of the population is getting older and the average age is higher than it was five years ago.”
Both Yocum and Donmoyer offered the same hypothetical answers when asked why older individuals are dying from drug overdoses and the average age is ticking upward.
“You are asking me a million dollar question,” said Donmoyer. “I mean, everyone has an opinion on things and I don’t like to say things that I can not prove. If you asked 10 people you would get 10 different answers.”
He believes older people are more likely to overdose due to pain issues and how people are medically treated for their pain.
“It can be about how people are treated medically for their pain, and sometimes that turns into an addiction,” said Donmoyer. “People don’t have insurance to afford medications, so they turn to street drugs to manage their pain. 18- and 20-year-olds don’t have pain issues.”
Jackson emphasized that Yocum’s thoughts were strictly his and not based on any proof or statistics. His educated guess is based on observations he’s made within his practice.
“His feeling from seeing people coming into the doctor’s office is that the uptick has a lot to do with people’s financial difficulties, which is why we’re seeing this happening with older folks,” said Jackson. “They may not be able to afford their meds. If they are on disability or social security, that’s just not enough to live on. People are overwhelmed with their finances, keeping up with their bills and paying for their medications.”
Officials for both agencies continue to fight for the lives of Lebanon countians.
Donmoyer told LebTown his agency has distributed over 1,000 cases of Narcan annually for the past several years to various organizations, school districts and others who have requested them. 2023 witnessed the biggest distribution yet at 1,248 cases. One kit has two containers filled with 4 milligrams each of spray and 12 kits come in a case. “Sometimes you have to use a second one, so that’s why one kit comes with two containers.”
Donmoyer said Narcan is distributed for free through his office.
“Joe Q. Public can get it, nurses in our school districts can get it from us, HACC downtown can get it, we supplied Lebanon Valley College, we have provided it to the Lebanon County government, and we have made it available to our service providers in the county,” he said.
Drug users can also request from his office at no cost and no questions asked fentanyl and xylazine test strips to determine if their narcotics have been laced with those substances. The commission is also working to save lives by utilizing funding the county is receiving through the National Opioids Settlement program.
Read More: Lebanon County sets sites on treatment programs for opioid and other drug addictions
Lebanon County’s mental health department conducts numerous awareness events throughout the year, including the Lebanon County Mental Health Awareness Festival on May 18 from 10 a.m. to 1 p.m. at Poplar Commons.
Kasey Felty, director of mental health for MH/ID/EI, said there will be 40 wellness and service providers at the festival, which is free and open to the public. The event will feature a DJ, educational sessions, outdoor yoga, a wellness walk and horses and goats to meet and have interaction with, among other events.
Leahy speaks for here department and the alcohol and drug commissions when she says, “We want to help, we want to be there for folks.”
If you are struggling with suicidal thoughts, experiencing a mental health crisis or dealing with alcohol or drug substance abuse, you can call the Lebanon County Crisis Intervention Hotline at 717-274-3363 for free and confidential counseling.
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